This guest blog is from Linda Hoenigsberg, LCPC, LMFT, DBTC, a psychotherapist in private practice, who will be offering an online DBT skills class.
For the sufferer of borderline personality disorder (BPD), feelings of hopelessness can be pervasive. Those folks with BPD willing to seek help may have been to a number of treatment centers or countless therapists; they may have spent many late evenings in the emergency room of their local hospital. At times things seem to be getting better. Then something happens and they feel as if they have made no progress at all.
Family members also struggle in their ability to understand or feel compassion for themselves or their loved one—especially when something has triggered symptoms. Sometimes, in well-meaning attempts to help control the behaviors of one suffering from BPD, fears of abandonment or feelings of anger get triggered and both family members or friends and those suffering the symptoms of BPD feel like retreating to their own corners.
But one of the core skills of Dialectical Behavior Therapy, Core Mindfulness, can be very helpful for both family members and the person diagnosed. These techniques can help both parties calm and soothe themselves in reactive situations.
Core Mindfulness: The Key Ingredient in Treatments for BPD?
Borderline personality disorder is part heritable and part environmental. When a person begins to practice mindfulness skills, they are targeting the part that is environmental (approximately 40%), and this can lead to a much-improved life. In fact, this can lead to a much-improved brain, even if one has never practiced mindfulness before.
If you’ve never practiced mindfulness, there are some great books out there to get you started. You may want to check out Mindfulness for Borderline Personality Disorder by Gillian Galen and Blaise Aguirre, a psychiatrist widely recognized for his work in the treatment of personality disorders. You might also want to read Jon Kabat Zinn’s Mindfulness for Beginners,” or How to Train A Wild Elephant, by Jan Chozen Bays, MD, or One Minute Mindfulness, by Donald Altman. These easy-to-digest books can help you find your way.
You Must Have Compassion for Others, Grasshopper
A fascinating study by Richard Davidson (2001) clearly demonstrates how a certain kind of mindfulness practice actually increases activity in the left side of the brain, the left prefrontal cortex. This side of the brain is where we generate positive feelings, such as joy and well-being, while the right prefrontal cortex is activated by negative thoughts and emotions.
By practicing purposely focusing our thoughts on feelings of love and compassion towards others, the left prefrontal cortex is activated. Dr. Blaise Aguirre writes about this in this quarter’s issue of Borderline Personality Disorder Magazine. According to Aguirre,
The data thus shows that regular practice of loving compassion activates the area of the brain that experiences joy and that allows us to consider that others might experience things differently from the way that we do. Both of these ideas are of profound importance to developing well-being in people with BPD.
Since the left prefrontal cortex of people who are stressed out or depressed has been shown to be underactive, this is huge.
So What’s the Big Deal About That?
That means that with regular practice, we can up the level of activity in the part of our brain that leads to more happiness and can lower the activity in the right prefrontal cortex, where our negative thoughts and emotions seem to reside. We can also experience more compassion for ourselves if we have problems regulating our emotions.
And if we are family members or other support members of someone who has been diagnosed, we can experience more compassion for ourselves and for our family members in moments when it gets tough to be in the trenches.
So What Does This Look Like in Real Life?
Daily practice is key to making changes in your brain circuitry. Once a behavior is over-learned, it is the “go to,” behavior, and you do not have to relearn it. It’s much like learning how to ride a bike. At first you felt uncomfortable. You had to try to coordinate the actions of your feet on the pedals, pushing them forward, and steering all at the same time. You also had to think about how to use the break when you needed it. It took practice.
Many of you started with training wheels, and that first ride without them was scary and exciting. You built a skill. You mastered it. Now, if you didn’t ride a bike for several years, chances are you could still just climb aboard and go! Your muscles overlearned the skill and it became second nature.
It is the same with any skill. If you learn some deep-breathing exercises, unless you overlearn them by practicing them daily, you will be hard pressed to find them helpful the next time you have a major panic attack.
So on a daily basis, practice loving-kindness mindfulness. Think of someone for whom you already have feelings of love and care. Meditate on that person for 10-20 minutes, purposely drawing your heart toward them with thoughts for their well-being and love. As you continue this practice, add others to your list. As Aguirre suggests in his book, eventually offer this compassion in your mind to all of mankind…and especially yourself! Picture this exercise activating the left side of your brain and lowering activity in the right side of your brain.
This type of mindfulness practice may not work for everyone, but research suggests it is very helpful. Mindfulness has been studied to help those with depression, anxiety, substance abuse, and even chronic pain. Take a closer look at this core skill. It may just change your life.
Linda Hoenigsberg, LCPC, LMFT, DBTC, is a psychotherapist in private practice. She lives with her husband in the Rocky Mountains of Montana. You can find her at www.changeyouremotions.com, where she will soon offer an online DBT Skills Course. Her main website is www.lindahoenigsberg.com.